HomeMy WebLinkAboutD Mackinnon Permit app.All APPLIIC�ABLE f FO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
Date: "t/z1/Z,0ZJ
Permit Number: _
LLJ LLL
Building Permit Application
Planning and Development Services
Building and Code Regulation Division Commercial
2300 Virginia Avenue, Fort Pierce FL 34982 Residential _
Phone: (772) 462-1553 Fax: (772) 462-1578
PERMIT APPLICATION FOR: Do'-4
V�
PROPOSED IMPROVEMENT LOCATION:
Address:
Property Tax ID #: 5WAt - b 6 3 Site Plan Name:
Project Name:
DETAILED DESCRIPTION OF WORK:
MGLClki AnC,(\
r- L 3Ll922
New Electrical Meter Second Electrical Meter
(Affidavit required)
CONSTRUCTION INFORMATION:
Lot No. 8
Block No.
Additional work to be performed under this permit- check all that apply:
_Mechanical _ Gas Tank _ Gas Piping _ Shutters Windows/Doors _ Pond
— Electric _ Plumbing _ Sprinklers
_Generator _Roof Pitch
Total Sq. Ft of Construction:
Sq. Ft. of First Floor:
Cost of Construction: $ �� q .-C-' Utilities: — Sewer _ Septic Building Height:
OWNER/LESSEE: CONTRACTOR:
Name QAytA J%j4; iyuos9
Address: 13d 7 Wk#,4 &4k (X
City: ;;Vt ekn4o State: &
Zip Code: Mg14 Fax:
Phone No. 1 *- 1e26- D`.SS
E-Mail:JMA—za I 7194h1LJl dom
Fill in fee simple Title Holder on next page { if different
from the Owner listed above)
Name: J4i`{0_h,e 11
Company: OM4.iY dv- ;[sue
Address: lgltl e-44WAZ aud? l
City: -j t-714ac1lle State: /`L-
Zip Code: 121 tO Fax: Nltf
Phone No 7-22 -2i32-70/1
E-M a i I �4 ewx5r 4'Ud �S4P aSQ yf ew •dwt
State or County License 62e 13.4 ?1p3
If value of construction is 2500 or more, a RECORDED Notice of Commencement is required.
If value of HAVC is $7,500 or more, a RECORDED Notice of Commencement is required.
SUPPLEMENTAL CONSTRUCTION LIEN LAW INFORMATION:
®ESIGNER/ENGINEER: Not A licable
Name:
Not —Applicable
MORTGAGE COMPANY.
Address: Name:
City: Address:
State: City:
Zip: Phone Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable
BONDING COMPANY:
Name:
Address:
Name:
City:
Address:
Zip: Phone:
City.
Zip: Phone:
Not —74 Applicable
State:
Not Applicable
OWNER/ CONTRACTOR AFFIDVIT: Application is hereby made to obtain a permit to do the work and installation as indicated.
I certify that no work or installation has commenced prior to the issuance of a permit.
St. Lucie Countyy makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in co I lict with any applicable Home Owners Association rules, bylaws or and covenants that may restrict or prohibit such
structure. Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit, I do hereby agree that I will, in all respects, perform the work
in accordance with the approved plans, the Florida Building Codes and St. Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review: room additions,
accessory structures, swimming pools, fences, walls, signs, screen rooms and accessory uses to another non-residential use
WARNING TO OWNER: Your failure to Record a Notice of Commencement may result in paying twice for
improvements to your perty. A Notice of Commencement must be recorded in the public records of St.
Lucie County an ed n the jobsite before the first inspection. If you intend to obtain financing, consult
with lender r torn before Commencing work or recording our Notice of Commencement.
Signature of Owner/Lessee/Contractor as Agent for Owner
STATE OF FLORIDA
COUNTY OFs!Y
Sworn tor affirmed) and subscribed before me of
this ay of 1UDUffibe -e- 20;21 by A— Physical Presence or Online Notarization
Name of person making statement.
Personally Known ,_ OR Produced Identification
1'ypP of Identification Produced
(Signature oa ic- State of Florida )
Commission No.k� UW U j (Seal)
REVIEWS FRONT ZONING
COUNTER REVIEW
DATE
RECEIVED
DATE
COMPLETED
Notary Public State of Florida
lg tey Lynn Green
My Commiaaion HH 041915
w Expiros 09/13/2024
SUPERVISOR
I REVIEW VEGETATIONS REVIEW LE I MANGROVE